Anxiety & OCD Flashcards
4 features of pathologic anxiety?
autonomy (no trigger)
high intensity
long duration
results in disabling behaviors
10 anxiety imposters?
hyperthyroid, hyperadrenalism, CHF, angina, anemia, COPD, acidosis, hyperthermia, seizures, vestibular dysfunction
Causes of substance-induced anxiety?
caffeine, cocaine, stimulants
withdrawal from downers
3 neurophysiologic causes of anxiety?
high norepi (locus coeruleus) low GABA (limbic) low 5HT
Anxiety tx?
CBT
SSRI/SNRI long term
benzos for an acute episode
6 common anxiety disorders?
separation anxiety disorder panic disorder agoraphobia generalized anxiety disorder specific phobia social anxiety disorder
When is separation anxiety appropriate?
ages 1-3
Separation anxiety tx?
exposure therapy
What are panic attacks?
discrete episodes of intense anxiety
lasts about 10 minutes
Panic disorder criteria?
recurrent panic attacks
no trigger
disrupts function/alters behavior
What is agoraphobia?
anxiety in the following settings: public transport open spaces enclosed places crowds outside of the home alone
GAD criteria?
anxiety most days for 6mo unable to control worry somatic symptoms impaired function no specific trigger
6 GAD somatic symptoms?
muscle tension restlessness insomnia difficulty concentrating fatigue irritability
GAD tx?
CBT
SSRI/SNRI
benzos
buspirone
Tx for specific phobia?
graded exposure
What is social anxiety disorder?
fear of social situations and being scrutinized by others
Social anxiety tx?
CBT
SSRI/SNRI
benzos or beta blockers for situational
What is an obsession?
recurrent thought or image
What is a compulsion?
behaviors aimed at reducing distress
OCD criteria?
obsessions or compulsions that are time-consuming or cause impaired functioning
What is ego-dystonic?
not enjoyable for the ego
What is ego-syntonic?
ego likes it
Are obsessions ego-dys-or-syntonic?
dystonic
OCD tx?
CBT (exposure)
SSRI
clomipramine (TCA)
What is body dysmorphic disorder?
preoccupation with a slight or nonexistant flaw
repetitive cosmetic surgeries
5 symptom categories of ASD/PTSD?
intrusive thoughts and memories negative mood dissociative (depersonalization or derealization) avoidance of thoughts, places, or people hyperarousal
Acute Stress Disorder criteria?
stress symptoms lasting 3 days - 1 month
impairs functioning
Post Traumatic Stress Disorder criteria?
stress symptoms lasting more than 1mo
ASD/PTSD tx?
exposure based CBT
SSRI
NO benzos
Adjustment disorder criteria?
non-life threatening stressor triggers distress symptoms lasting 3-6mo
distress is out of proportion to stressor
Adjustment disorder tx?
supportive therapy
CBT
can use SSRI
Mature defense mechanisms?
SASH: sublimation altruism suppression humor
